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https://www.readbyqxmd.com/read/29746546/transcatheter-aortic-valve-implantation-for-aortic-stenosis-in-high-surgical-risk-patients-a-systematic-review-and-meta-analysis
#1
Zulian Liu, Elaine Kidney, Danai Bem, George Bramley, Susan Bayliss, Mark A de Belder, Carole Cummins, Rui Duarte
BACKGROUND: Symptomatic aortic stenosis has a poor prognosis. Many patients are considered inoperable or at high surgical risk for surgical aortic valve replacement (SAVR), reflecting their age, comorbidities and frailty. The clinical effectiveness and safety of TAVI have not been reviewed systematically for these high levels of surgical risk. This systematic review compares mortality and other important clinical outcomes up to 5 years post treatment following TAVI or other treatment in these risk groups...
2018: PloS One
https://www.readbyqxmd.com/read/29743064/patient-directed-self-management-of-pain-padsmap-compared-to-treatment-as-usual-following-total-knee-replacement-a-randomised-controlled-trial
#2
Katherine H O Deane, Richard Gray, Paula Balls, Clare Darrah, Louise Swift, Alan B Clark, Garry R Barton, Sophie Morris, Sue Butters, Angela Bullough, Helen Flaherty, Barbara Talbot, Mark Sanders, Simon T Donell
BACKGROUND: Self-administration of medicines by patients whilst in hospital is being increasingly promoted despite little evidence to show the risks and benefits. Pain control after total knee replacement (TKR) is known to be poor. The aim of the study was to determine if patients operated on with a TKR who self-medicate their oral analgesics in the immediate post-operative period have better pain control than those who receive their pain control by nurse-led drug rounds (Treatment as Usual (TAU))...
May 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29725893/moral-conflicts-and-religious-convictions-what-role-for-clinical-ethics-consultants
#3
John C Moskop
Moral conflicts over medical treatment that are the result of differences in fundamental moral commitments of the stakeholders, including religiously grounded commitments, can present difficult challenges for clinical ethics consultants. This article begins with a case example that poses such a conflict, then examines how consultants might use different approaches to clinical ethics consultation in an effort to facilitate the resolution of conflicts of this kind. Among the approaches considered are the authoritarian approach, the pure consensus approach, and the ethics facilitation approach described in the Core Competencies for Healthcare Ethics Consultation report of the American Society for Bioethics and Humanities, as well as a patient advocate approach, a clinician advocate approach, and an institutional advocate approach...
May 3, 2018: HEC Forum: An Interdisciplinary Journal on Hospitals' Ethical and Legal Issues
https://www.readbyqxmd.com/read/29680895/patent-foramen-ovale-and-stroke
#4
Bruno Miranda, Ana Catarina Fonseca, José M Ferro
A patent foramen ovale (PFO) is a highly prevalent finding in cryptogenic ischaemic stroke, particularly in young adults. A common challenge in clinical practice is to distinguish between incidental and pathogenic PFO. Some clinical features and tools such as the Risk of Paradoxical Embolism score may help determining the probability of a stroke-related PFO. Nonetheless, the best therapeutic option to reduce stroke recurrence after a cryptogenic stroke with PFO has been a matter of debate for a long time. We review the mechanisms of stroke-related PFO, together with its clinical features and diagnostic criteria...
April 21, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29677993/shared-medical-imaging-repositories
#5
Rui Lebre, Luís Bastião, Carlos Costa
This article describes the implementation of a solution for the integration of ownership concept and access control over medical imaging resources, making possible the centralization of multiple instances of repositories. The proposed architecture allows the association of permissions to repository resources and delegation of rights to third entities. It includes a programmatic interface for management of proposed services, made available through web services, with the ability to create, read, update and remove all components resulting from the architecture...
2018: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/29664455/physician-awareness-of-decompressive-hemicraniectomy-for-malignant-middle-cerebral-artery-infarction-in-saudi-arabia-and-the-gulf-countries
#6
Hosam M Al-Jehani, Abdulaziz Alsharydah, Seba A Rammal, Saleh S Baeesa, Mohammad Mekhlafi
OBJECTIVE: To explore the perspective on Decompressive craniectomy (DH) of each of these specialties to establish common grounds for improved clinical practice. METHODS: An electronic survey was distributed via email and social media groups to members of these specialties in Kingdom of Saudi Arabia and the Gulf countries. Local practices, common triggers for referral for DH, perceived outcomes of these procedures, individual impression of what constitutes good clinical outcomes were explored...
April 2018: Neurosciences: the Official Journal of the Pan Arab Union of Neurological Sciences
https://www.readbyqxmd.com/read/29576442/effect-size-in-efficacy-trials-of-women-with-decreased-sexual-desire
#7
REVIEW
Robert E Pyke, Anita H Clayton
BACKGROUND: Regarding hypoactive sexual desire disorder (HSDD) in women, some reviewers judge the effect size small for medications vs placebo, but substantial for cognitive behavior therapy (CBT) or mindfulness meditation training (MMT) vs wait list. However, we lack comparisons of the effect sizes for the active intervention itself, for the control treatment, and for the differential between the two. AIM: For efficacy trials of HSDD in women, compare effect sizes for medications (testosterone/testosterone transdermal system, flibanserin, and bremelanotide) and placebo vs effect sizes for psychotherapy and wait-list control...
March 22, 2018: Sexual Medicine Reviews
https://www.readbyqxmd.com/read/29526779/tuberculous-spondylolisthesis-a-re-appraisal-on-clinico-radiologic-spectrum-and-surgical-treatment-paradigm
#8
REVIEW
Vinayak Narayan, Nasser Mohammed, Amey R Savardekar, Devi Prasad Patra, Anil Nanda
INTRODUCTION: Spinal tuberculosis [TB] is a common infectious disease prevalent in developing countries and a rising disaster in developed countries. The association of tuberculosis with spondylolisthesis is rarely reported in literature. The aim of our review is to analyse the clinical features and radiologic characteristics of TB spondylolisthesis along with providing a concise update on its surgical management, based on current literature. METHODS: A systematic review is performed after conducting a thorough search in the PubMed database...
March 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29505327/transcatheters-for-closure-of-patent-foramen-ovales
#9
Gianluca Rigatelli, Marco Zuin
Nowadays patent foramen ovale (PFO) closure is considered clinically beneficial and even cost-effective over medical therapy in secondary prevention of stroke due to paradoxical embolism. Areas covered: In this review, the authors discuss both anatomical and technical details and constructive concepts of current devices used for PFO closure. Expert commentary: Right atrial and interatrial septum anatomy is more complex than usually thought and a unique prosthesis that fits properly to all the possible morphologies is far from being designed...
April 2018: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/29500568/patent-foramen-ovale-closure-or-medical-therapy-for-cryptogenic-ischemic-stroke-an-updated-meta-analysis-of-randomized-controlled-trials
#10
Volker Schulze, Yingfeng Lin, Athanasios Karathanos, Maximilian Brockmeyer, Tobias Zeus, Amin Polzin, Stefan Perings, Malte Kelm, Georg Wolff
BACKGROUND: Previous randomized controlled trials (RCT) failed to demonstrate benefits of patent foramen ovale (PFO) closure (PFO-C) over medical therapy (MT) for secondary prevention of cryptogenic ischemic stroke. Three recently published RCTs, however, turned out positive for PFO-C and warrant an updated meta-analysis. METHODS: Data from all available RCTs on PFO-C vs. MT for secondary prevention of cryptogenic ischemic stroke up until October 2017 were abstracted and analyzed in a comprehensive meta-analysis...
March 2, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29473804/can-they-do-that-the-limits-of-governmental-power-over-medical-treatment
#11
Paul Jerome McLaughlin
No abstract text is available yet for this article.
July 2017: Journal of Legal Medicine
https://www.readbyqxmd.com/read/29460090/medical-big-data-warehouse-architecture-and-system-design-a-case-study-improving-healthcare-resources-distribution
#12
Abderrazak Sebaa, Fatima Chikh, Amina Nouicer, AbdelKamel Tari
The huge increases in medical devices and clinical applications which generate enormous data have raised a big issue in managing, processing, and mining this massive amount of data. Indeed, traditional data warehousing frameworks can not be effective when managing the volume, variety, and velocity of current medical applications. As a result, several data warehouses face many issues over medical data and many challenges need to be addressed. New solutions have emerged and Hadoop is one of the best examples, it can be used to process these streams of medical data...
February 19, 2018: Journal of Medical Systems
https://www.readbyqxmd.com/read/29437499/primer-on-state-statutory-mandates-of-third-party-orthodontic-coverage-for-cleft-palate-and-craniofacial-care-in-the-united-states
#13
Kristin D Pfeifauf, Alison Synder-Warwick, Gary B Skolnick, Sybill D Naidoo, Richard J Nissen, Kamlesh B Patel
Provision and timing of orthodontic treatment is a crucial part of comprehensive cleft palate and craniofacial care. Some states statutorily mandate orthodontic coverage for the medically necessary care of cleft palate and craniofacial anomalies. However, application of the medically necessary standard varies broadly. Disputes over medical necessity lead to orthodontic coverage denials and surgical intervention delays. Provider-friendly statutory definitions of medical necessity enable patients and providers to avoid such hurdles...
March 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29420964/metabolic-surgery-weight-loss-diabetes-and-beyond
#14
REVIEW
Manan Pareek, Philip R Schauer, Lee M Kaplan, Lawrence A Leiter, Francesco Rubino, Deepak L Bhatt
The alarming rise in the worldwide prevalence of obesity is paralleled by an increasing burden of type 2 diabetes mellitus. Metabolic surgery is the most effective means of obtaining substantial and durable weight loss in individuals with obesity. Randomized trials have recently shown the superiority of surgery over medical treatment alone in achieving improved glycemic control, as well as a reduction in cardiovascular risk factors. The mechanisms seem to extend beyond the magnitude of weight loss alone and include improvements in incretin profiles, insulin secretion, and insulin sensitivity...
February 13, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29391144/predicting-distal-aortic-remodeling-after-endovascular-repair-for-chronic-debakey-iii-aortic-dissection
#15
Ibrahim Sultan, Mary A Siki, Joseph E Bavaria, Taylor R Dibble, Danielle C Savino, Arman Kilic, Wilson Szeto, Prashanth Vallabhajosyula, Ronald M Fairman, Benjamin M Jackson, Grace J Wang, Nimesh D Desai
BACKGROUND: Chronic DeBakey III (CD3) aortic dissection is typically managed with open aortic reconstruction. Thoracic endovascular aortic grafting (TEVAR) has been attempted in patients with CD3 with improved outcomes over medical management, however with frequent failures. This study investigates factors associated with positive aortic remodeling from a large aortic center. METHODS: Three dimensional reconstructions (M2S, West Lebanon, NH) of computed tomography angiography scans of 48 patients who underwent TEVAR from 2005 to 2015 were analyzed...
January 29, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29383514/closure-of-patent-foramen-ovale-for-cryptogenic-stroke-patients-an-updated-systematic-review-and-meta-analysis-of-randomized-trials
#16
REVIEW
Xuan Niu, Guang Ou-Yang, Peng-Fei Yan, Shu-Lan Huang, Zhen-Tao Zhang, Zhao-Hui Zhang
OBJECTIVE: This systematic review and meta-analysis was performed to investigate the efficacy and safety of transcatheter device closure (TDC) plus anti-thrombotic drugs over medical management alone for patients with cryptogenic stroke and patent foramen oval. METHODS: PubMed, Embase and Cochrane Library database were searched for randomized controlled clinical trials (RCTs). The primary endpoint is the composite of stroke and transient ischemic attack. The secondary endpoints are all-cause mortality, total serious adverse events, atrial fibrillation and bleeding...
January 30, 2018: Journal of Neurology
https://www.readbyqxmd.com/read/29360070/-reduction-of-inappropriate-prescriptions-and-adverse-effects-to-medications-in-hospitalized-elderly-patients
#17
Ana Fajreldines, Eduardo Schnitzler, Jorge T Insua, Mariana Valerio, Laura Davide, Marcelo Pellizzari
Together, potentially inappropriate prescribing of medications (PIP) and appropriate prescribing omission (APO) constitute a problem that requires multiple interventions to reduce its size and the occurrence of adverse drug events (ADE). This study aims to assess PIP, APO, ADE before and after the intervention of a clinical pharmacist over medical prescriptions for elderly hospitalized patients. In a before-after study, a total of 16 542 prescriptions for 1262 patients were analyzed applying the criteria defined in both STOPP- START (screening tool of older people's prescriptions and screening tool to alert to right treatment)...
2018: Medicina
https://www.readbyqxmd.com/read/29351694/treatment-outcomes-for-right-sided-endocarditis-in-intravenous-drug-users-a-systematic-review-and-analysis-of-outcomes-in-a-tertiary-centre
#18
Karen Magsino, Rohan Sanjanwala, Brett Hiebert, Janet Rothney, Rizwan Manji, Rakesh Arora, Pallav Shah
BACKGROUND:  The increasing prevalence of intravenous drug users (IVDU) has resulted in higher incidence of right-sided infective endocarditis (RSIE). However, treatment guidelines for RSIE in IVDU are not well defined. The aim is to evaluate efficacy of different treatment strategies in reducing mortality and to describe treatment outcomes. METHODS:  We systematically reviewed the literature using PubMed, Cochrane, CENTRAL, OvidEMBASE, Web of Science, and Medline databases to include prospective studies that compare mortality rates among IVDU with RSIE receiving isolated medical treatment versus those receiving medical-surgical treatment...
January 19, 2018: Thoracic and Cardiovascular Surgeon
https://www.readbyqxmd.com/read/29305234/reproductive-outcomes-after-fertility-sparing-surgery-for-focal-and-diffuse-adenomyosis-a-systematic-review
#19
REVIEW
Justin Tan, Sophie Moriarty, Omur Taskin, Catherine Allaire, Christina Williams, Paul Yong, Mohamed A Bedaiwy
Among the variety of treatment options to improve reproductive outcomes for infertile women with adenomyosis (AD), uterine-conserving surgery has shown varying success. Hence, we conducted a systematic review around the topic of fertility-sparing surgery across 18 studies and 1396 infertile women with focal and diffuse AD. Patients with focal AD showed mean pregnancy and miscarriage rates of 52.7% (range,14.3%-77.5%) and 21.1% (range, 0%-44.4%), respectively, whereas patients with diffuse AD had mean pregnancy and miscarriage rates of 34...
January 2, 2018: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/29184740/can-friedberg-s-triad-solve-persistent-anesthesia-problems-over-medication-pain-management-postoperative-nausea-and-vomiting
#20
Barry L Friedberg
Friedberg's Triad is (1) measure the brain; (2) preempt the pain; (3) emetic drugs abstain. Persistent anesthesia problems include over- and under-medication, postoperative pain management, and postoperative nausea and vomiting. Inspired by Vinnik's diazepam-ketamine paradigm, Friedberg's propofol ketamine paradigm was first published in 1993. The 1997 addition of the bispectral (BIS) index brain monitor made the propofol ketamine paradigm numerically reproducible. The 1998 addition of the frontalis electromyogram (EMG) as a secondary trend to the BIS transformed the time-delayed BIS monitor into a real-time, extremely useful device...
October 2017: Plastic and Reconstructive Surgery. Global Open
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